During hot/humid weather, a ten-year-old Fire constitution gelding was presented for Traditional Chinese Veterinary Medicine (TCVM) evaluation and treatment of a pelvic limb shifting leg lameness (4 week duration) and idiopathic head shaking (1 week). The lumbosacral muscles were tense and firm. While trotting, a 3/5 lameness was observed in the right pelvic limb and the horse shook his head violently. The stifle diagnostic acupoints were most sensitive, but sensitivity was also noted on hock and hip acupoints bilaterally. The tongue was initially red with a yellow coating and the carotid pulses were strong, forceful and wiry (bilateral). The TCVM diagnosis was local Qi Stagnation in the lumbosacral region and right pelvic limb and Liver Qi Stagnation and Fire Flaring Upward to the Heart causing a Shen Disturbance (head shaking). Dry needles were inserted into Bai-hui, Shen-shu, Shen-peng, Shen-jiao, BL-54, BL-40 bilaterally for Qi Stagnation and Xia-guan, Shang-guan, Nao-shu, An-shen, HT-7 for Shen Disturbance. Hemoacupuncture was performed at HT-9 to clear Heat. Two acupuncture treatments were administered, 1 week apart. The local Qi Stagnation resolved within a month. The head shaking worsened and evidence of Heart Yin and Blood Deficiency developed. The Chinese herbal medicine, Shen Calmer (modified Tian Wang Bu Xin Dan), was prescribed. After 2 weeks of herbal therapy, the head shaking had improved and within 2 months the horse showed only occasional head shaking while being ridden. When the hot summer months had past, the herbal therapy was discontinued, and the clinical signs had disappeared.